Value-Based Insurance Design Yields Near- and Long-Term Improvements in Medication Adherence

March 2013

Medication adherence is critical to the management of chronic conditions. Yet, many patients forgo medication when confronted with unmanageable or rising medication costs, a phenomenon termed cost-related nonadherence. Value-based insurance design (VBID) is a benefit design strategy that aims to align patient cost sharing with the value of a particular clinical service, often by eliminating or reducing copayments for effective treatments. In a HCFO-funded study, Matthew Maciejewski, Ph.D., Duke University School of Medicine and Durham VA Medical Center, and colleagues explored the business case for value-based insurance design, including VBID’s impact on adherence for a range of medications used to manage chronic disease. They assessed near- and long-term effects on medication adherence after the initiation of VBID in a Blue Cross Blue Shield of North Carolina plan, and they found differential effects based on participants’ baseline adherence. Their findings were published in the May 2012 issue of the American Journal of Managed Care.